Vol 22, No 1 (2016)

The article considers organizational issues of functioning of the oblastnoii perinatal council of physicians related to maintenance of availability of obstetric-gynecologic care of pregnant women on territory of the Chelyabinskaia oblast. The analysis of functioning of oblast perinatal council of physicians “The oblastnoii perinatal center” is presented with purpose of increasing of effectiveness of medical care of pregnant women.

The article presents the results of analysis of loss of density of endothelium cells after endothelium keratoplastry with formation of ultra-thin transplant using femtosecond laser from side of endothelium (UTinvFS-DSEK). The study sampling included 22 patients underwent UTinvFS-DSEK during 2012-2014 in the Helmholtz Moscow research institute of eye diseases. The average time-period of observation made up to 9.6 ± 4.3 months. The Fuchs dystrophy occurred in 31.8%, secondary dystrophy - in 45.4%, inconsistency of endothelium of kerato-transplant - in 22%. All patients were applied photo-registration, visiometry, auto-refractokeratometry, bio-microscopy, tonometry, kerato-analyzing, optical coherent tomography of front segment, confocal microscopy. During the first three years after transplantation, the average loss by endothelium cells made up to 60% of initial level. At that, average loss of density of endothelium cells made up to 1256 ± 450 cells per mm2. In time-periods of six months after surgery the average loss of density of endothelium cells made up to 64% of initial level. The loss of density of endothelium cells remained at the level of 64% after 12 months. In two patients under observation the average density of endothelium cells made up to 996±161 cells per mm 2 after 24 months. The analysis of dynamics of loss by endothelium cells after applied keratoplastry with formation of transplant using femtosecond laser from the side of endothelium demonstrated that received values of loss by cells in existing time-periods exceed, according publications' data, similar indicator after reach-through keratoplastry, standard endokeratoplastry and transplantation of Descemet's membrane with endothelium. The actual study has such certain limitations as average time-periods of observation, limited number of patients, minimal number of patients within time-period more than 24 months.

The article presents the results of evaluation of gender characteristics of clinical somatic and psycho-emotional status in patients with chronic heart failure and old myocardium infarction, including analysis of their relationship with psycho-emotional conditions and possibilities of pharmaceutical correction. All patients were subjected to common techniques of clinical examination including, besides medical history information gathering, physical examination, test with six minutes walking, evaluation of clinical conditions according NYHA scale (R. Cody, 1993 modification of V.Yu. Mareiev 2000). The sampling for examination included 150 patients survived myocardium infarction, 75 males and 75 females. All examined patients were randomized on three groups. The patients of first group (25 males and 25 females) were given basic therapy and Perindopril (Prestarium, Servier) as inhibitor of angiotensin converting enzyme in dosage of 5-10 mg per day. The patients of second group (25 males and 25 females) besides basic therapy were given Valsartanum (Diovan, Novartis) in dosage of 80-160 mg per day. The scheme of treatment of patients of third group (25 males and 25 females) besides basic therapy (with inhibitor of angiotensin converting enzyme and/or blocker of angiotensin receptors) included Sertralinum (Zoloft, Phizer) in dosage of 50 mg per day. In the group of examined patients with chronic heart failure and old myocardium infarction, males were younger than females. The psycho-emotional overloads as risk factor were observed more frequently in female patients. It is established that in group of patients with chronic heart failure and old myocardium infarction frequently occurs diabetes mellitus being that in 2.3 times more often in females than in males. The arterial hypertension was detected in all females with chronic heart failure and old myocardium infarction. The duration of arterial hypertension also has its characteristics: females suffered from arterial hypertension twice more often than males. The applied therapy provided comparative clinical effect both in males and females of all groups. Against the background of therapy the maximal effect was observed in group of patients received Perindopril in combination with Sertralinum. The following gender characteristics of risk factors in patients with chronic heart failure and old myocardium infarction were detected: in females arterial hypertension was occurred 1.4 times more often (100%) and diabetes mellitus was detected 2.3 times more often (30%) in comparison with males. The duration of arterial hypertension also had gender characteristics because females suffered from arterial hypertension 2 times more often than males. Taking into account increased level of anxiety in most of the patients with chronic heart failure and old myocardium infarction the application of Sertralinum in composition of combined therapy results in additional positive clinical effects that is expressed more reliably in females.

The article presents the organizational institutional model of pharmaceutical support of patients with socially significant diseases in the Republic of Kazakhstan

The present publications' review considers perspectives of application of statins under pulmonary hypertension. Nowadays, there are quite encouraging experimental data concerning positive versatile effect of statins on lesser blood circulation. The results of study of this issue with participation of patients are singular and continue to be controversial still. The clinical substantiation of application of new pharmaceuticals effecting molecular mechanisms of pathogenesis of pulmonary hypertension (re-modeling, endothelial dysfunction, function of right ventricle) requires carrying out of large investigations placebo-controlled by design and statistical processing. Precisely in this context the application of statins is of interest as potentially strategic direction in treatment of pulmonary hypertension.

The article considers genetic susceptibility to development of diabetes mellitus type II, its micro-vascular complications and intensity of response under application of incretin therapy depending on carriage of polymorphism of gene TCF7L2 involved into WNT-path and incretin axis.